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14: Advances in ablative and non-ablative lasers in gynecology: A clinician's guide

      Objective

      The purpose of this educational video is to describe the biophysics of fractional ablative and non-ablative lasers used in gynecology including a procedural demonstration.

      Description

      Laser technology is a relatively new tool for gynecology. The first laser was invented in the 1960s and by 2000, low energy minimally invasive lasers were used in dermatology. In the last three years, dozens of laser manufactures have started marketing fractional ablative and non-ablative technology for office based procedures. Non-ablative and fractional techniques have revolutionized the field of skin rejuvenation and resurfacing by providing dermal focused therapy at low energy levels. The low energy levels improve patient tolerance and decrease downtime. This technology has been used in conditions such as atrophic vaginitis, vaginal laxity, lichen sclerosus, and stress urinary incontinence. The American College of Obstetricians and Gynecologist issued a statement about fractional laser treatments in 2016. The FDA has only cleared, but not approved, this surgical technology. The clearance does not describe any disease or pathologies approved for treatment. Most of the research is observational and short term at this time. There are current trials in place focusing on comparative treatment options and long term data to fill this research void.

      Conclusion

      This video will provide an introduction for gynecologic surgeons on the basic science and biophysics of laser technology and a summary of available outcome data for vaginal and vulvar conditions.